Archive for the ‘Medicare Fraud and Scams’ Category

Doctor pleads guilty to Medicare fraud again

Monday, May 11th, 2009

Miami-Dade doctor Carmen Lourdes del Cuerto pleaded guilty again last week to participating in a Medicare fraud scheme with four other doctors between 2003 and 2006. Del Cuerto and the four other doctors were accused of prescribing approximately $19.5 million in drugs for HIV patients who did not need or receive the therapy. The doctors submitted false claims and were paid almost $16 million by the federal health insurance program.

Dr. Carmen del Cuerto faces up to 10 years for Thursday’s conviction and March’s conviction of a $10 million HIV infusion scam. Her sentencing is set for September and she must also repay Medicare $4.5 million.

Medicare schemes in South Florida have been abundant in recent years and the state of Florida is doing everything they can to stop the fraud before it occurs.

Florida House passes bill on Medicare fraud

Wednesday, April 29th, 2009

Due to the many cases of Medicare fraud in the past year in Florida, the House unanimously voted and passed tighter rules on licensing for health service providers in the hopes of reducing healthcare fraud, specifically Medicare and Medicaid fraud.

As a result of the many Medicare scandals in South Florida recently (over 600 fraud offenders in the past three years), Rep. David Rivera has designated Miami-Dade county as a “healthcare fraud area of special concern.” Any person wanting to be licensed to operate a home health agency, medical equipment provider, or health clinic will need to be a resident of the United States for at least 5 years, unless the applicant files a bond of at least $500,000.

“Everyone should be concerned about Medicare and Medicaid fraud because every taxpayer in this state pays for this fraud,” Rep. Rivera said. “But we should be particularly concerned when the fraud benefits a criminal government like Cuba.”

The bill, which was cleared by the House 114-0, bans new licenses in counties with a high number of home health agencies, including Dade and Broward counties.

Medicare Fraud left and right

Friday, April 24th, 2009

Last month we heard it out of Miami, now we’re hearing it out of Houston. A June 26 sentencing is scheduled for 3 people who were accused of Medicare fraud the other day. The $36 million Medicare billing fraud included Rhonda Fleming, 45, Bose Ebhamen, 45, and King Arthur, 54. The three were convicted on Wednesday for 3 counts; health care fraud, conspiracy to defraud Medicare, and wire fraud. Rhonda Fleming and Bose Ebhamen were also convicted of money laundering. These three are facing up to 20 years on each of the counts.

Medicare fraud has been on the news a lot recently. In recent years, Medicare fraud schemes have resulted in hundreds of millions of dollars in false billings to Medicare. Most Medicare fraud happens when people bill Medicare for services that were never provided. For example, a doctor may bill Medicare for a service that you came in for yet you never were at the doctor. Fraud most commonly occurs in billing for institutional facilities (hospitals, nursing homes, etc.), billing for physician services and visits, and billing for medical equipment.

There are a few ways that you can avoid medicare scams:

  • Examine any notices you get from Medicare and make sure you received all the services and prescriptions listed.
  • Protect your Medicare card number and don’t give the information to anyone else
  • Never accept medical supplies from door to door salespeople
  • Don’t accept “free” services in return for your Medicare number
  • Educate yourself about Medicare and know your rights.

If you suspect Medicare fraud, call your health care provider and contact the U.S. Department of Health and Human Services at 1-800-447-8577

2 Doctors Convicted of Medicare Fraud

Thursday, March 19th, 2009

Two Miami doctors and their assistants were convicted on Tuesday for plotting to submit millions of dollars in bogus bills to Medicare. On top of that, they manipulated blood samples, falsified medical records, and wrote prescriptions for HIV patients who didn’t need their obsolete drugs. The two doctors, Keith Russell and David Rothman, and their two assistants, Jorge Luis Pacheco and Eda Marietta Milanes, were found guilty by a federal jury for conspiring to commit fraud for filing $5.3 million in false HIV-therapy claims with Medicare.

The case stands out because one of the accused, Jorge Luis Pacheco, violated the terms of his bond, cut off his ankle monitor and tried to flee to the Dominican Republic. He told officials he was “going fishing.”

This isn’t the first time Rothman and Russell committed fraud. Rothman has written for about $60 million in phony HIV treatments from 2004 to 2005 and Russell wrote prescriptions totaling millions of dollars at other clinics. Both doctors’ sentencing is on June 26 and until then they are on house arrest. Pacheco, who tried to flee, and Milanes are being held at the Federal Detention Center in Miami.